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dc.contributor.authorAhmad, Saquib
dc.date.accessioned2019-02-20T14:01:25Z
dc.date.available2019-02-20T14:01:25Z
dc.date.issued2018-12
dc.identifier.citationWhite, J. R. et al. (2018) ‘Narrow band imaging and serology in the assessment of premalignant gastric pathology’, Scandinavian Journal Of Gastroenterology, 53(12), pp. 1611–1618. doi: 10.1080/00365521.2018.1542455.en
dc.identifier.urihttp://hdl.handle.net/20.500.12904/1471
dc.descriptionPre-print or Post-print available.en
dc.description.abstractBACKGROUND: Patient outcomes in gastric adenocarcinoma are poor due to late diagnosis. Detecting and treating at the premalignant stage has the potential to improve this. Helicobacter pylori is also a strong risk factor for this disease. AIMS: Primary aims were to assess the diagnostic accuracy of magnified narrow band imaging (NBI-Z) endoscopy and serology in detecting normal mucosa, H. pylori gastritis and gastric atrophy. Secondary aims were to compare the diagnostic accuracies of two classification systems using both NBI-Z and white light endoscopy with magnification (WLE-Z) and evaluate the inter-observer agreement. METHODS: Patients were prospectively recruited. Images of gastric mucosa were stored with histology and serum for IgG H. pylori and Pepsinogen (PG) I/II ELISAs. Blinded expert endoscopists agreed on mucosal pattern. Mucosal images and serological markers were compared with histology. Kappa statistics determined inter-observer variability for randomly allocated images among four experts and four non-experts. RESULTS: 116 patients were prospectively recruited. Diagnostic accuracy of NBI-Z for determining normal gastric mucosa was 0.87(95%CI 0.82-0.92), H. pylori gastritis 0.65(95%CI 0.55-0.75) and gastric atrophy 0.88(95%CI 0.81-0.94). NBI-Z was superior to serology at detecting gastric atrophy: NBI-Z gastric atrophy 0.88(95%CI 0.81-0.94) vs PGI/II ratio < 3 0.74(95%CI 0.62-0.85) p<.0001. Overall NBI-Z was superior to WLE-Z in detecting disease using two validated classifications. Inter-observer agreement was 0.63(95%CI 0.51-0.73). CONCLUSIONS: NBI-Z accurately detects changes in the GI mucosa which currently depend on histology. NBI-Z is useful in the detection of precancerous conditions, potentially improving patient outcomes with early intervention to prevent gastric cancer.en
dc.language.isoenen
dc.subjectGastritisen
dc.subjectEndoscopyen
dc.subjectNarrow band imagingen
dc.subjectIntestinal Metaplasiaen
dc.titleNarrow band imaging and serology in the assessment of premalignant gastric pathology.en
dc.typeArticleen


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